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Comparison of distensibility of the aortic root and cusp motion after aortic root replacement with two reimplantation techniques: Valsalva graft versus tube graft

Division of Cardiovascular, Thoracic, and Pediatric Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan

*Corresponding author. Tel.: +81 78 382 5942; fax: +81 78 382 5959.

E-mail address: yokita{at}med.kobe-u.ac.jp (Y. Okita).

The aim of this study is to evaluate distensibility of the aortic root and function of the aortic cusp after aortic root replacement using valve sparing procedure. Between October 1999 and August 2006, valve sparing aortic root replacements were performed in 39 patients who had annuloaortic ectasia (AAE) and aortic valve regurgitation. Reimplantation type of valve-sparing procedure was performed with a tube graft (n=12) or a Valsalva graft (n=27). Echocardiographic studies were performed six months after the operation comparing Valsalva graft (Group V, n=15), tube graft (Group T, n=5), and normal control (Group C, n=5). Percent changes in radius (PCR) of the aortic root were measured as indices of distensibility. Rapid valve opening velocity (RVOV/HR (mm/s/min)) and rapid valve closing velocity (RVCV/HR (mm/s/min)) of the aortic cusp were analyzed in each group. Root distensibility of sinus in Group T (1.9±1.1) was significantly smaller than Group C (7.2±1.8) (P=0.003). RVOV/HR in Group T was highest among the three groups (T: 48.2±6.2, V: 36.2±11.9, C: 33.7±9.6). RVCV/HR showed no difference among the three groups (T: 26.1±6.7, V: 40.7±16.6, C: 28.4±16.3). In conclusion, sinus distensibility of the Valsalva graft was well preserved and valve-opening characteristics with the Valsalva graft were identical to normal.

Key Words: Valve sparing operation; Aortic root distensibility; Aortic valve function; Aortic root replacement